[Rehabilitation for intravaginal ejaculatory dysfunction with using a masturbation aid].

OBJECTIVES: Recently the incidence of intravaginal ejaculatory dysfunction is increasing among infertile couples in Japan. Some unusual ways of masturbation and psychogenic issues were reported to cause this disorder. Patients, who had done masturbation in an unusual way for long time since their adolescence, were difficult to gain normal intravaginal ejaculation by the behavior therapy which was used for erectile dysfunction. We, therefore, used a masturbation aid (TENGA) for rehabilitation of ejaculation to overcome this condition. PATIENTS AND METHODS: From January, 2010 through March, 2011, a total of 16 patients with intravaginal ejaculatory dysfunction underwent rehabilitation of ejaculation using TENGA. Patients' satisfaction and achievement of intravaginal ejaculation were evaluated by the questionnaire. RESULTS: Twelve patients (75%) could ejaculate in the masturbation aid (TENGA). Five patients (31%) succeeded to ejaculate in the partner's vagina after rehabilitation. CONCLUSIONS: A masturbation aid (TENGA) was a useful tool to correct the way of masturbation and achieve normal intravaginal ejaculation. This masturbation aid can be one of the effective options for the treatment of intravaginal ejaculatory dysfunction.

Mullerian duct cyst: a curable entity of male infertility. Two case reports.

Purpose: Mullerian duct cyst is a rudiment of a Mullerian duct in the fetal period which causes ejaculatory duct obstruction and male infertility. Case report: We report two patients with Mullerian duct cyst that presented with low ejaculate volume, oligoasthenoteratozoospermia and azoospermia syndrome. Transrectal ultrasound (TRUS) and magnetic resonance image (MRI) revealed a midline prostatic cystic structure. In each case, we performed a TRUS guided transperineal aspiration of the cyst. Seminograms of the patients improved and one of their wives got spontaneously pregnant 3 months after the surgery. Conclusion: We should assume the TRUS guided aspiration of Mullerian duct cyst.